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促进印度综合慢性病管理模式参与者自我管理糖尿病和抑郁症的患者激活的因素。

Factors that facilitate patient activation in the self-management of diabetes and depression among participants enrolled in an integrated chronic care model in India.

机构信息

Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA; Emory School of Medicine, Emory University, 201 Dowman Drive, GA, 30322, USA.

Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA.

出版信息

Soc Sci Med. 2021 Feb;270:113646. doi: 10.1016/j.socscimed.2020.113646. Epub 2020 Dec 24.

DOI:10.1016/j.socscimed.2020.113646
PMID:33486424
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7888586/
Abstract

BACKGROUND

The aim of this study was to identify factors that influence patients' motivation and ability to self-manage their diabetes and depressive symptoms.

METHODS

From 2016 to 17, in-depth interviews were conducted with 62 patients receiving the INDEPENDENT care model across two clinics in India. Using a realist evaluation approach, a hypothesized program theory for patient activation was tested and refined.

FINDINGS

The refined theory demonstrates that motivation, education, and engagement cumulatively contribute to patient activation.

CONCLUSION

The results indicate that positive and sustained patient-provider relationships drive patient motivation and enhance implementation of the care model.

摘要

背景

本研究旨在确定影响患者自我管理糖尿病和抑郁症状的动机和能力的因素。

方法

2016 年至 2017 年,在印度的两个诊所中,对接受 INDEPENDENT 护理模式的 62 名患者进行了深入访谈。使用现实主义评估方法,对患者激活的假设方案理论进行了测试和完善。

结果

完善后的理论表明,动机、教育和参与共同促进了患者的激活。

结论

结果表明,积极和持续的医患关系推动了患者的积极性,并增强了护理模式的实施。

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本文引用的文献

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Effect of a Collaborative Care Model on Depressive Symptoms and Glycated Hemoglobin, Blood Pressure, and Serum Cholesterol Among Patients With Depression and Diabetes in India: The INDEPENDENT Randomized Clinical Trial.印度一项针对伴发抑郁和糖尿病患者的随机临床试验(INDEPENDENT)表明,协同护理模式可改善抑郁症状及糖化血红蛋白、血压和血清胆固醇水平。
JAMA. 2020 Aug 18;324(7):651-662. doi: 10.1001/jama.2020.11747.
2
Are people-centred mental health services acceptable and feasible in Timor-Leste? A qualitative study.以人为中心的精神卫生服务在东帝汶是否可行和可接受?一项定性研究。
Health Policy Plan. 2019 Nov 1;34(Supplement_2):ii93-ii103. doi: 10.1093/heapol/czz108.
3
Key attributes of patient centered medical homes associated with patient activation of diabetes patients.与糖尿病患者的患者激活相关的以患者为中心的医疗之家的关键属性。
BMC Fam Pract. 2018 Jan 5;19(1):4. doi: 10.1186/s12875-017-0704-3.
4
The association between patient activation and self-care practices: A cross-sectional study of an Australian population with comorbid diabetes and chronic kidney disease.患者激活与自我护理实践之间的关联:一项澳大利亚合并糖尿病和慢性肾脏病人群的横断面研究。
Health Expect. 2017 Dec;20(6):1375-1384. doi: 10.1111/hex.12577. Epub 2017 Jul 4.
5
The role of Patient Health Engagement Model (PHE-model) in affecting patient activation and medication adherence: A structural equation model.患者健康参与模型(PHE模型)在影响患者激活和药物依从性方面的作用:一种结构方程模型。
PLoS One. 2017 Jun 27;12(6):e0179865. doi: 10.1371/journal.pone.0179865. eCollection 2017.
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The INtegrating DEPrEssioN and Diabetes treatmENT (INDEPENDENT) study: Design and methods to address mental healthcare gaps in India.整合抑郁症与糖尿病治疗(独立)研究:解决印度精神卫生保健差距的设计与方法
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